MB:
So, we’ve touched on sleep in the past and there’s a fair amount of science connecting sleep and ADD. But the question that immediately comes to my mind is, what’s chicken and what’s egg? Are the sleep problems creating the Attention Deficit Disorder or is the ADD creating the sleep problems? Because we know, just in day to day life, that we don’t get a good night’s sleep and we’re grumpy and we can’t concentrate, we’re distracted easily. Pretty classic ADD symptoms. So, which is chicken and which is egg?

JM:
That’s really a great question for any of these diagnostic categories, and especially the ones such as Attention Deficit Disorder, the major depressive disorders and the bipolar disorders that have significant sleep problems associated with them. Now Marc, the trouble is that it’s not a one size, fits all, and it’s not a single entity etiology or cause. It’s just like we’ve learned in genetics, you can’t just find one gene that throws a switch and things happen, it takes lots and lots of switches thrown. And to develop a mental disorder, there’s some good research that these are poly issue or multi-etiology vectors. Now, sleep’s a big one.

JM:
In my clinical experience over a number of years… 40 years… And in my reviews as a researcher over 40 years, which are pretty extensive, it can be 20% to 25% in ADHD or some of these mood disorders. There’s good reasons for that. Sleep is a complex skill. It requires quieting of one of the alerting nervous systems and then activation of one of the more internally-focused and regulatory nervous systems… That’s a big shift. It requires a lot of management of neurohormones, of muscle tone and tension. It requires hygiene or shutting out the world so that these switches and these changes in focus, internally and externally, occur. It requires a lot of things. So, sleep is a major contributor. It’s a major contributor to recovery, in my opinion, in ADHD. If you’re not assessing at least and focusing on the family and the individual’s skill set and approach to sleep, you’re gonna have a hard time with long term success in treatment.

MB:
So, what I’m hearing you saying when you talk about many vectors or etiologies, meaning ADD has many forces creating it, there’s many causes and those causes are potentially different makeups for different people. Now, you pulled out one concept that I really liked and I wanna touch a little bit more on that. Sleep as a skill. We don’t typically think of sleep as a skill, and yet really you’re saying that science teaches us that that is in fact the case. Now, obviously we have issues with stimulation, being alert, we take stimulants for ADD much of the time, and then we have trouble with sleep. So, we’re having trouble with stimulation and rest or recovery, both. Could you explain that a little bit?

Jerry Morris, PsyD, MSPharm, MBA

Dr. Morris is former President and current Executive Director of the American Board of Medical Psychology. He has owned and operated mental health hospitals and community centers and has run residency-training programs. He has managed clinical programs that treat lifestyle related diseases and is a member of the American College of Lifestyle Medicine.

Your support counts!

LifestyleFACTS.org is brought to you by The Lifestyle Medicine Foundation. The Lifestyle Medicine Foundation is a 501c3 nonprofit organization dedicated to informing the public and health care practitioners about lifestyle medicine. We accomplish this through evidence-based LifestyleFACTS web content as well as through other methods of outreach. Our goal is to broadly disseminate educational, scientific and research information about lifestyle medicine to help patients live vibrant, high quality and healthier lives.